Gi4SaveLife: a community-led model for sustainable voluntary blood donation in rural Sierra Leone.

Sierra Leone faces critical blood shortages reliant on family replacement and paid donors, contributing to high maternal mortality. Traditional top-down blood drives have failed to build sustainable voluntary donor bases due to mistrust and logistical barriers. We developed 'Gi4SaveLife', a community-led model to foster local ownership and sustainable donation. Implemented in Kono and Kenema districts, this quality improvement initiative established community 'hubs' led by local volunteers responsible for peer-to-peer education and mobilisation. We conducted a baseline survey to identify barriers, followed by monthly blood drives using non-monetary incentives. Data on collection volumes, donor demographics and costs were tracked over 8 months. The initiative collected 539 units from 376 unique donors, moving from zero voluntary donations at baseline to a consistent supply. Crucially, 43% (161) were repeat donations, indicating a committed donor pool. The cost per unit decreased by 40% compared with standard NGO-led models. Key motivators included altruism (71%) and social recognition (52%). Gi4SaveLife demonstrates that a community-led approach, grounded in ownership and trust, can establish a cost-effective, sustainable pipeline of voluntary donors in low-resource settings. This model offers a scalable framework to bolster national blood transfusion services by bridging the gap between communities and health facilities.